J Thromb Haemost:阿哌沙班和达肝素在活动性恶性肿瘤相关的静脉血栓栓塞中的疗效

2019-10-21 xing.T MedSci原创

由此可见,接受VTE治疗的癌症患者口服阿哌沙班与较低的大出血和VTE复发率相关。

低分子量肝素是针对癌症相关静脉血栓栓塞(VTE)指南推荐的治疗方法。尽管阿哌沙班被批准用于治疗急性VTE,但支持其在癌症患者中使用的数据有限。

近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,该研究的主要结局为大出血,次要结局包括VTE复发以及重大与临床相关的非重大出血(CRNMB)。研究人员将与癌症相关的VTE患者随机分配接受阿哌沙班10mg,每天两次,共7天,然后5mg,每天两次,共6个月,或皮下注射达肝素(200IU/kg,1个月,然后每天150IU/kg)。

在300例随机分组的患者中,287例患者纳入进行主要分析。66%的受试者存在转移性疾病;74%正在接受同步化疗。145名接受阿哌沙班治疗的患者中没人发生了大出血,而142名接受达肝素治疗的患者中有1.4%的患者发生了大出血(p=0.138;由于阿哌沙班组中无出血事件,无法估计风险比(HR))。0.7%接受阿哌沙班治疗的患者发生复发性VTE,而达肝素患者为6.3%(HR为0.099,95%CI为0.013-0.780,p=0.0281)。两组的大出血或CRNMB发生率均为6%。

由此可见,接受VTE治疗的癌症患者口服阿哌沙班与较低的大出血和VTE复发率相关。 

原始出处:

Robert McBane II.et al.Apixaban and Dalteparin in Active Malignancy Associated Venous Thromboembolism: The ADAM VTE Trial.Journal of Thrombosis and Haemostasis.2019.https://onlinelibrary.wiley.com/doi/10.1111/jth.14662

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    2020-06-19 xue8602
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    2020-04-08 xlysu
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    2020-09-20 changfy
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    2020-06-24 fusion
  5. [GetPortalCommentsPageByObjectIdResponse(id=1955457, encodeId=16b7195545ecc, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Fri Jun 19 00:40:00 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747684, encodeId=95f21e4768478, content=<a href='/topic/show?id=73fe93955ff' target=_blank style='color:#2F92EE;'>#达肝素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93955, encryptionId=73fe93955ff, topicName=达肝素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=edf435938443, createdName=xlysu, createdTime=Wed Apr 08 16:40:00 CST 2020, time=2020-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008441, encodeId=d47f2008441f9, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sun Sep 20 22:40:00 CST 2020, time=2020-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697986, encodeId=7b82169e986c4, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Wed Jun 24 16:40:00 CST 2020, time=2020-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723978, encodeId=76711e23978a2, content=<a href='/topic/show?id=2d996516e7c' target=_blank style='color:#2F92EE;'>#活动性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65167, encryptionId=2d996516e7c, topicName=活动性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=596833562866, createdName=楚秀娟, createdTime=Fri Jul 31 17:40:00 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269164, encodeId=4275126916470, content=<a href='/topic/show?id=4f99651e3bb' target=_blank style='color:#2F92EE;'>#活动性恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65173, encryptionId=4f99651e3bb, topicName=活动性恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=991e83, createdName=wincls, createdTime=Wed Oct 23 09:40:00 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032312, encodeId=bbe2103231216, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Oct 21 21:40:00 CST 2019, time=2019-10-21, status=1, ipAttribution=)]
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    2019-10-21 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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